| NPI | 1366898967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61725) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33848) |
| 1223G0001X Dentist, General Practice (Licence: MO 2020022127) | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2022-11-15 |