| NPI | 1609600667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 40950) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: TX 40950) |
| Enumeration Date | 2024-08-30 |
| Last Update Date | 2024-08-30 |