| NPI | 1770812182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MO 2015017079) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2015017079) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2026-01-30 |