| NPI | 1366017121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 12987) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 12987) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-09-01 |