| NPI | 1477829927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist Orofacial Pain (Licence: AZ D010117) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041154) |
| 122300000X Dentist (Licence: CA 61249) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2019-10-08 |