| NPI | 1790137313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 100952) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA DN1857307) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2020-09-22 |