| NPI | 1992154355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MO 2021013067) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61151) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2021-07-14 |