| NPI | 1194967174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA A122340) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 56523) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2018-09-10 |