| NPI | 1326707381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: IA 40217) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: TX 38043) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2023-01-18 |