| NPI | 1518452705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: OR MD216829) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: OR D12107) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MA DN1859258) | |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2025-05-24 |