| NPI | 1225461106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 13123) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0442000186) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 9076) | |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2024-04-25 |