| NPI | 1811426406 |
|---|---|
| Former Name | IVETTE LANDRIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10643) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 10643) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2023-04-12 |