| NPI | 1780161398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 107287) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: WV 4353) |
| 1223P0700X Dentist, Prosthodontics (Licence: TX 35970) | |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2022-01-26 |