| NPI | 1003312968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: DC DEN2000049) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401416819) |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2021-09-29 |