| NPI | 1871664805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: SC SC 3399) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: SC PROS 0532) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |