| NPI | 1578295242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 62228) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 2484) |
| 122300000X Dentist (Licence: FL DRPM2484) | |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2024-03-31 |