| NPI | 1609389121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MD LL862) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: KY 10039) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2020-10-25 |