| NPI | 1669613485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 33669) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OH 2732) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: TX 33669) | |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2024-06-11 |