| NPI | 1871127209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 7117) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 36234) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401416859) | |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-10-20 |