| NPI | 1912392374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61473) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001392) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2024-05-03 |