| NPI | 1669031704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PR 3323) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 3323) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2023-03-31 |