| NPI | 1366544645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO DEN-10560) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901018217) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901018217) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2012-09-04 |