| NPI | 1659412237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61574) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D12335) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2019-08-19 |