| NPI | 1679258040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 62142) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 28051) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2023-06-21 |