| NPI | 1104054816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: GA DNF000375) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 28616) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2021-10-25 |