| NPI | 1770802613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ 54225) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AZ 54225) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NC 2022-03116) | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2023-01-23 |