| NPI | 1609217744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 056665) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02472700) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 010797) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2014-01-27 |