| NPI | 1942430939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NC 8845) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8845) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2012-08-31 |