| NPI | 1881140473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 22123) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: AZ D011241) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2022-05-27 |