| NPI | 1083863633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 2026) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 9473) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2024-12-12 |