| NPI | 1437478914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 058393-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D12874) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2020-03-12 |