| NPI | 1083026181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: TX 32487) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: NC 150963) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2020-01-13 |