| NPI | 1306082128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NV S2-135) |
| Additional Taxonomies | 122300000X Dentist (Licence: TN ANO4005272179) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 164) | |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2021-07-29 |