| NPI | 1619167020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MD 14255) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401411794) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2015-10-23 |