| NPI | 1730117029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN17573) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 17573) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2022-08-03 |