| NPI | 1649426230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NH 1903) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA 14485-1) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MD 07325) | |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |