NPI | 1013179530 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SD D0901) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NM DD3715) |
Enumeration Date | 2008-06-26 |
Last Update Date | 2013-09-04 |