| NPI | 1861931149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA DDS106266) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CO DEN.00205035) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2022-11-18 |