NPI | 1437635224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 061553) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02856200) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS041839) | |
Enumeration Date | 2018-07-14 |
Last Update Date | 2024-07-23 |