| NPI | 1508114323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 28258) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 28258) |
| 1223G0001X Dentist, General Practice (Licence: SC 10057) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 10096) | |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2024-07-26 |