| NPI | 1083849178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-228) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 5790) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2011-09-15 |