NPI | 1184774044 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 20553) |
Additional Taxonomies | 122300000X Dentist (Licence: MA 20553) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2025-10-17 |