| NPI | 1912015934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: WI 2926) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: WI 2926) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2011-09-14 |