| NPI | 1144581703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-238) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 61134) |
| 122300000X Dentist (Licence: NV 5982) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2013-06-17 |