| NPI | 1578689055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 8938426-9921) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NV 4160) |
| 1223P0700X Dentist, Prosthodontics (Licence: PA DS024284L) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-07-15 |