| NPI | 1033349170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist Orofacial Pain (Licence: CA 60841) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 60841) |
| 122300000X Dentist (Licence: PA DS037830) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2020-04-28 |