| NPI | 1689125213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: GA DN123038) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16028) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2023-05-25 |