| NPI | 1275204380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CT 13280) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61086406) |
| 1223P0700X Dentist, Prosthodontics (Licence: WA DE61086406) | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-10-20 |