| NPI | 1831612332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN27120) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: KS 61450) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2025-01-31 |