| NPI | 1851844641 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 100569)  | 
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR MD205899)  | 
| Enumeration Date | 2016-07-27 | 
| Last Update Date | 2023-06-30 |