| NPI | 1346533627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MD 14775) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 14775) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2018-03-22 |