| NPI | 1306948559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 60432) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2006021037) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2021-07-07 |