| NPI | 1447788955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: DE G1-0011509) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS041242) |
| Enumeration Date | 2017-05-28 |
| Last Update Date | 2023-09-14 |