NPI | 1245788777 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401416033) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12012490A) |
Enumeration Date | 2016-09-13 |
Last Update Date | 2020-06-02 |