| NPI | 1023416120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN S200) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN S200) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV LL-383-14) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA DDS103268) | |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2025-01-28 |