| NPI | 1245993336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901601081) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901601081) |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2024-08-07 |