| NPI | 1346909702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 10472) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 9622) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2024-02-13 |