| NPI | 1386847648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA A124009) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CA DDS59583) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2021-10-12 |