| NPI | 1538476775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 8911) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: KY 8911) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2015-01-07 |