| NPI | 1871187856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401417362) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401417362) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 17313) | |
| Enumeration Date | 2021-02-21 |
| Last Update Date | 2021-07-20 |