| NPI | 1396142154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 103187) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02577200) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 057915) | |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2022-01-13 |