NPI | 1942287586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: SC 3435) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 3435) |
Enumeration Date | 2005-12-25 |
Last Update Date | 2015-09-26 |