| NPI | 1326814591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 40387) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401418698) |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2024-07-01 |