| NPI | 1023009669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: UT 10267883-9924) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TN 7445) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2021-11-02 |