| NPI | 1649567595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TX Q2701) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 43011098896) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TX 30519) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KS 60715) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: PA DS040747) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NC 2013-01019) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2016-06-01 |