| NPI | 1821352238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: WA MD.MD.608788868) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D10995) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2025-08-07 |