| NPI | 1518606235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61873) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2022019284) |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |