NPI | 1760646566 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 9264) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.027630) |
Enumeration Date | 2008-07-11 |
Last Update Date | 2013-09-17 |