| NPI | 1013307982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: WA de60584579) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 28429) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2019-02-20 |