| NPI | 1306256276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PR 3295) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS PRV-FP-108-20) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 058198-1) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2021-09-01 |