| NPI | 1194750059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 13636) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13636) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-04-14 |