| NPI | 1790942829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CO DEN.00202631) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: GA DNO13828) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2021-10-13 |