| NPI | 1336162049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22682) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D07202) |
| 1223X2210X Dentist, Orofacial Pain (Licence: AZ D0702) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2023-06-30 |