| NPI | 1073366373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: OK 25511) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: MN S192) |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2025-10-02 |