| NPI | 1790201838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: PR 3509) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 35834) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2025-09-16 |