NPI | 1114310943 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: FL DN21538) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: GA 92077) |
204E00000X Oral & Maxillofacial Surgery (Licence: SC DGD.10930) | |
Enumeration Date | 2015-03-18 |
Last Update Date | 2024-09-11 |