| NPI | 1669080214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2020022417) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2020022417) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2025-01-02 |