| NPI | 1467647164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: TX 24515) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 24515) |
| 1223P0700X Dentist, Prosthodontics (Licence: WI 156-875) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2012-12-13 |