| NPI | 1972588374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OR D9062) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS029168L) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: OR MD28633) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2018-11-13 |