| NPI | 1386963718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: KS 04-41292) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: SD D1107) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2021-07-15 |