| NPI | 1477077139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: MA DN1858617) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901022417) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-08-26 |