| NPI | 1538372891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 9787) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D12342) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AK 1215) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2012-05-17 |