| NPI | 1578884557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NC 10756) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN013626) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2022-07-21 |