NPI | 1992890537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: TX 19701) |
Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: TX 19701) |
2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: TX 19701) | |
Enumeration Date | 2006-10-03 |
Last Update Date | 2009-10-14 |