| NPI | 1609288554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: WA DE60276603) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: VA 0401413511) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2022-07-21 |