| NPI | 1376100651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61812) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2019019147) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2021-07-08 |