| NPI | 1730751520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 1002563-15) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9191) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 2901600969) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D14611) | |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2023-09-24 |