| NPI | 1669450706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 00203077) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 034298) |
| 1223P0700X Dentist, Prosthodontics (Licence: OR D9970) | |
| 1223P0700X Dentist, Prosthodontics (Licence: MI 017008) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2023-07-11 |