| NPI | 1104372796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC DGD.10420) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 8786) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-03-15 |