| NPI | 1407142540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: ME DEN4746) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NY 059105-1) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2019-10-02 |