| NPI | 1942349899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 4167) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: NC 5699) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |