| NPI | 1417299132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 203147) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: WA DR60360447) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2018-03-17 |