| NPI | 1821491440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KS 61931) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2014029525) |
| 1223E0200X Dentist, Endodontics (Licence: MN D14170) | |
| Enumeration Date | 2014-09-28 |
| Last Update Date | 2022-12-02 |