| NPI | 1770010043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN28672) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN1857916) |
| 122300000X Dentist (Licence: NJ 22DI02632900) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2024-06-13 |