| NPI | 1831633296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OK 270) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 6887) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2024-08-21 |