NPI | 1649440595 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA 48671) |
Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: CA 48671) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 48671) | |
Enumeration Date | 2008-03-06 |
Last Update Date | 2024-12-04 |