| 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 |