| NPI | 1245476423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 8832) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 5711) |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2024-01-05 |