| NPI | 1487800918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MD 16739) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16739) |
| 122300000X Dentist (Licence: MI 2901019804) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MI 2901019804) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2022-11-30 |