| NPI | 1609458983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID 5261) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 16388) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ID D-5261-OR) | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-04-02 |