| NPI | 1548654049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS043013) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 51032) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2022-12-09 |