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 |