| NPI | 1679676191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: KY 6659) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: KY 34369) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2015-08-11 |