| NPI | 1588150957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM DD5285) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 33914) |
| 122300000X Dentist (Licence: TX 33914) | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2021-04-06 |