NPI | 1386100949 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: LA 7617) |
Additional Taxonomies | 122300000X Dentist (Licence: LA 7617) |
Enumeration Date | 2019-02-19 |
Last Update Date | 2025-02-14 |