| NPI | 1821208489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL DN18185) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 8m886141) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-07-22 |