| NPI | 1548883465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401417184) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA T64031276) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2022-07-22 |