| 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 |