| NPI | 1669674313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2014018750) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60490) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2014-07-21 |