| NPI | 1881116317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WV 147) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 4566) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2026-01-12 |