| NPI | 1326277047 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: FL DN23768) | 
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NY 057880-1) | 
| Enumeration Date | 2009-07-02 | 
| Last Update Date | 2019-01-18 |