| NPI | 1629484076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 104328) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL 20615) |
| 122300000X Dentist (Licence: FL DN 20615) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO DEN.00203793) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2024-04-15 |