| NPI | 1740272111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NC 5982) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NC 9900779) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2007-07-08 |