| NPI | 1417087529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: DE G1-0001334) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 13965) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: DE G1-0001334) | |
| 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS036119) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2021-08-31 |