| NPI | 1265054407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX 39345) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MD 18414) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DI02793500) | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2024-12-04 |