| NPI | 1609181049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 0025828) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 25828) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2024-01-31 |