| NPI | 1619326766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 38671) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR PG188426) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: OR D10453) | |
| 122300000X Dentist (Licence: OR D10453) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2022-07-07 |