| NPI | 1356965586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61793) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN00204455) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2022-01-20 |