| NPI | 1780038752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 16234) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 9004) |
| 122300000X Dentist (Licence: MD 16234) | |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2026-08-08 |