| NPI | 1285253112 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MN 77495)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: MN D14456)  | 
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN 77495)  | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D14456)  | |
| Enumeration Date | 2020-04-10 | 
| Last Update Date | 2024-09-09 |