| NPI | 1710232707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AK 15707) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 157077) |
| 1223X2210X Dentist, Orofacial Pain (Licence: AK 15707) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2023-09-06 |