| NPI | 1477982551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 30196) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ 5600) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |