| NPI | 1184609497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NE 6569) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 6569) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2023-08-22 |