| NPI | 1770962953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 17375) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2020014141) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MO 2020014141) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 122300000X Dentist (Licence: IL 019030447) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2022-08-09 |