| NPI | 1245433408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: GA DN010854) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: DC DEN1000830) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-10-29 |