| NPI | 1053096222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: WA DE61264294) |
| Additional Taxonomies | 125Q00000X Oral Medicine (Licence: WA DE61264294) |
| 122300000X Dentist (Licence: WA DE61264294) | |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2026-05-13 |