| NPI | 1861589152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WI 5211015) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN 11730) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 16757) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2009-09-03 |