| NPI | 1568540540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 044226) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ DI17158) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 18098) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |