NPI | 1710522958 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OH 30.025691) |
Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 104695) |
122300000X Dentist (Licence: OH 30.025691) | |
Enumeration Date | 2019-11-12 |
Last Update Date | 2021-08-24 |