| NPI | 1306176276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KS 60756) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MO 2009028339) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2015-03-26 |