| NPI | 1124225560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DT588) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DT588) |
| 208600000X Surgery (Licence: VA 0101248090) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2014-01-10 |