| NPI | 1346626835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401415015) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021701) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2016-08-08 |