| NPI | 1811285182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2015012809) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 3816) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2019-07-19 |