| NPI | 1124766381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D14741) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 14567) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 11339) | |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2026-05-29 |