| NPI | 1992033914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: PR 2842) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PR 2842) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2012-11-13 |