| NPI | 1205169034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NV s543c) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN18071) |
| 122300000X Dentist (Licence: NJ DI024233) | |
| 1223P0700X Dentist, Prosthodontics (Licence: NY 055160-1) | |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2021-09-14 |