| NPI | 1790895910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 6532) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 6532) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-12-18 |