| NPI | 1093021362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TX 39880) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 59612) |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: PA DS043346) | |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2024-09-11 |