| NPI | 1356436265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: KS 60207) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KS 60207) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-08-21 |