| NPI | 1922414168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: KS 61312) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MO 2014021685) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2023-03-07 |