| NPI | 1679766794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 14075) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: DC DEN1000630) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |