| NPI | 1538689070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OK 87) |
| Additional Taxonomies | 122300000X Dentist (Licence: AL 6430) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-08-21 |