| NPI | 1366639189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PR 2700) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 2700) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2023-02-20 |