| NPI | 1124554829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 6437) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO DEN.00202223) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |