| NPI | 1033482500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: WI 6466-015) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 24510) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-02-14 |