| 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 |