| NPI | 1215203104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: CA 112621) |
| Additional Taxonomies | 208VP0000X (Licence: CA 112621) |
| 1223X2210X Dentist, Orofacial Pain (Licence: NY 056729) | |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2026-03-16 |