NPI | 1801907043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: OH 30-023357) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX F21974) |
1223P0700X Dentist, Prosthodontics (Licence: MI 2901016055) | |
1223P0700X Dentist, Prosthodontics (Licence: CO 8138) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2011-06-15 |