| NPI | 1770992935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D008901) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 31634) |
| 122300000X Dentist (Licence: TX 31634) | |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2016-09-21 |