| NPI | 1508314816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: NC 00176) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 00176) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2020-06-25 |