| NPI | 1811717382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 14440) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7869) |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2025-07-01 |