NPI | 1023416120 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN S200) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV LL-383-14) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA DDS103268) | |
Enumeration Date | 2014-12-05 |
Last Update Date | 2023-10-18 |