| NPI | 1073038519 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 38553) | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101635) | 
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019031847) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 101635) | |
| Enumeration Date | 2017-08-06 | 
| Last Update Date | 2025-01-27 |