| NPI | 1558814491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: NC 12546) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: NC 0225) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 151115) | |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2022-07-19 |