| NPI | 1508271834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2016027871) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61005) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2018-05-15 |