| NPI | 1053833996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: NC 00267) |
| Additional Taxonomies | 1223X2210X Dentist Orofacial Pain (Licence: NC 00267) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2024-01-02 |