| NPI | 1255589610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 14626) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1000961) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401412964) | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2019-07-05 |