| NPI | 1992181838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OR D10234) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR D10234) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2018-11-20 |