NPI | 1396843009 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA 60053) |
Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 137.000670.019.02690) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019026904) | |
Enumeration Date | 2006-09-20 |
Last Update Date | 2020-11-17 |