| NPI | 1467862854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NY 058350) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 33966) |
| 1223P0700X Dentist, Prosthodontics (Licence: TX 33966) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2019-12-16 |