| NPI | 1538420401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2013044561) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 60825) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2019-02-07 |