| NPI | 1982867487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN S144) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: KS 61124) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-08-11 |