| NPI | 1518171586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: FL DN 17738) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: CT 009014) |
| 1223P0700X Dentist Prosthodontics (Licence: MA 21517) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-08-08 |