| NPI | 1710501705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61958) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2021022288) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2025-10-03 |