| NPI | 1720398720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 055264) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02393700) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 59246) | |
| Enumeration Date | 2010-10-09 |
| Last Update Date | 2010-10-09 |