| NPI | 1699113159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401413793) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS038496) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 14926) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |