NPI | 1285166017 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401415509) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 050449-01) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 13003) | |
Enumeration Date | 2017-03-30 |
Last Update Date | 2022-07-26 |