| NPI | 1508028879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 60574) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2008017414) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2014-07-25 |