| NPI | 1124686100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: MA DF11952) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: MA DF11827) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2023-10-11 |