| NPI | 1750596284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 6148) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 7417) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |