NPI | 1902251358 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 10571) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: KY 10571) |
Enumeration Date | 2016-05-03 |
Last Update Date | 2021-09-06 |