| NPI | 1568020352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: WA DE61556525) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE61556525) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2025-03-15 |