| NPI | 1043592314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TX 37139) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 37139) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2024-01-17 |