| NPI | 1316327349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61158) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2015017431) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-11-20 |