| NPI | 1255304606 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: TX 37679)  | 
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: SC 8608)  | 
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: SC 873)  | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: PA DS030650L)  | |
| Enumeration Date | 2006-02-08 | 
| Last Update Date | 2022-08-10 |