NPI | 1578004347 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D15040) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: GA DN015941) |
Enumeration Date | 2017-03-14 |
Last Update Date | 2025-06-03 |