| NPI | 1134416746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 00204260) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855771) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN1855771) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 65339) | |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2020-06-18 |