| NPI | 1699158089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CT 11423) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 11423) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2024-01-04 |