| NPI | 1457543803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: FL 17538) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VA 0401411563) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401411563) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2011-06-15 |