| NPI | 1952689903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 10510) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CO 10510) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2025-02-07 |