| NPI | 1922293935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA OMS75) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A99211) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2015-06-10 |