NPI | 1538732102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 062028) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ DN23678) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL 22DI02831900) | |
Enumeration Date | 2021-07-21 |
Last Update Date | 2021-09-20 |