NPI | 1578280459 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: TX 40961) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DL15370) |
Enumeration Date | 2022-10-21 |
Last Update Date | 2024-11-19 |