| NPI | 1215929286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 009275) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CT 042206) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 050181) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NY 231685) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2012-08-08 |