| NPI | 1386277507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 600175115) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D10925) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: WI 8426620) | |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2025-08-03 |