| NPI | 1659801694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: MA DN1859943) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6761) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2023-08-24 |