| NPI | 1982151031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CO 00206542) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 9533) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0438000537) | |
| 208600000X Surgery (Licence: VA 0101286380) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 103516) | |
| 122300000X Dentist (Licence: VA 0401419565) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CO 0076987) | |
| 122300000X Dentist (Licence: TX 32375) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2026-09-03 |