NPI | 1588980767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA 143261) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 1797) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 60421) | |
Enumeration Date | 2010-04-14 |
Last Update Date | 2024-04-12 |