| NPI | 1992976427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 1000960) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 9594) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 9002) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: KY 9002) | |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2022-05-23 |