| NPI | 1255866786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61508) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2018014419) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2022-05-14 |