| NPI | 1891714143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: KS 60149) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MO 2002016022) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-05-12 |