| NPI | 1114021128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IA 7732) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: WI 4166) |
| 1223P0700X Dentist, Prosthodontics (Licence: MN D10491) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2007-07-08 |