NPI | 1780737627 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MO 2019002294) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2019002294) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2023-01-20 |