| NPI | 1083876189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 9248) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1000495) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 13720) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2012-04-10 |