| NPI | 1881615888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MI MI2683-92) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI MI2683-92) |
| 122300000X Dentist (Licence: OK 6573) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2015-05-20 |