| NPI | 1184242604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: TX 41826) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: KS 61755) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2025-08-07 |