| NPI | 1073532644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 8640) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200401268) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-08-11 |