| NPI | 1003239732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MT 17409) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 63915) |
| 1223G0001X Dentist General Practice (Licence: MT DEN-DEN-LIC-17409) | |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2023-01-02 |