NPI | 1164654216 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ D07864) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS038213) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ DI02354900) | |
Enumeration Date | 2009-08-21 |
Last Update Date | 2022-04-25 |