NPI | 1700165883 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN122229) |
Additional Taxonomies | 122300000X Dentist (Licence: CO 10519) |
Enumeration Date | 2011-08-08 |
Last Update Date | 2023-01-25 |