| NPI | 1316496896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 1001426-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001426 - 15) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2024-09-05 |