| NPI | 1083999585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: VT 016.0081258) |
| Additional Taxonomies | 122300000X Dentist (Licence: VT 0160081258) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2023-12-10 |