| NPI | 1427330554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-272) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6177) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2015-03-17 |