| NPI | 1962548511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: PA DS031329L) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS031329L) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA MD431474) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: PA MD431474) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2019-08-23 |