| NPI | 1750881397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2023005835) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D14084) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN ----) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2024-01-26 |