| NPI | 1225266943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PA DS039457) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MN D12734) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2013-07-03 |