| NPI | 1306622543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: PA RFD000064) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401418630) |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2023-09-05 |