| NPI | 1780137703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: LA 6446) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MS 3890-16) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 32729) | |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2020-08-20 |