| NPI | 1114420676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CT 77680) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 13976) |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2025-09-16 |