| NPI | 1962916783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MD 12731) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DC DEN1000677) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 49090) | |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2018-03-17 |