| NPI | 1265662894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR Df0032) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DL10607) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2015-08-19 |