| NPI | 1144459587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MN 56487) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D12815) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS040239) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2015-04-26 |