| NPI | 1548877194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: WA DE61096609) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401417138) |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2024-09-24 |