NPI | 1497190722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 06832) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NY 060912) |
Enumeration Date | 2013-04-30 |
Last Update Date | 2020-08-07 |