| NPI | 1396186011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN24511) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN 9714) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2020-05-17 |