| NPI | 1982274429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61835) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 106213) |
| 1223G0001X Dentist, General Practice (Licence: MO 2022012731) | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2022-05-04 |