NPI | 1851822753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OH 30.026637) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026637) |
Enumeration Date | 2017-03-22 |
Last Update Date | 2022-03-30 |