| NPI | 1912299728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: AZ D009284) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D009284) |
| 1223G0001X Dentist General Practice (Licence: AZ D009284) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2017-02-02 |