| NPI | 1376370064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 11237) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: KY 11237) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2024-12-02 |