| NPI | 1841676855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NY 057913) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 02602900) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CT 11391) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |