| NPI | 1477057818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: MI 2901600697) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 41982) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: WA DR60847787) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-09-10 |