| NPI | 1972580538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5711) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60291) |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2007-07-09 |