| NPI | 1770923005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: OK 39) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 7395) |
| 1223P0700X Dentist, Prosthodontics (Licence: MA DN1857177) | |
| 1223P0700X Dentist, Prosthodontics (Licence: CA 63030) | |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2022-01-09 |