| NPI | 1619518057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 10272) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10272) |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2023-05-23 |