| NPI | 1912225608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: NC 08976) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC AC5385578-R613) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2021-10-29 |