| NPI | 1306803093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PR 2400) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 2400) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-06-30 |