| NPI | 1265620181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: NV S1-27C) |
| Additional Taxonomies | 1223P0106X Dentist Oral and Maxillofacial Pathology (Licence: NY 052700) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2021-10-25 |