| NPI | 1811426679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2017017101) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61959) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2022-08-01 |