| NPI | 1811041726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: ME DEN4836) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 052809) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI02347100) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2021-02-04 |