NPI | 1891102992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401414476) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401414476) |
Enumeration Date | 2014-07-21 |
Last Update Date | 2023-10-31 |