| NPI | 1396146874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DTP670) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DTP670) |
| 122300000X Dentist (Licence: TX 30474) | |
| 1223P0700X Dentist, Prosthodontics (Licence: TX 30474) | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2020-03-03 |