| NPI | 1487769287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME88289) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: FL DN16594) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2022-06-14 |