| NPI | 1497182091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA DN1856958) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MI 2901020553) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2020-09-29 |