| NPI | 1649445826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 37677) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 37677) |
| 1223X2210X Dentist, Orofacial Pain (Licence: CA 37677) | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2024-04-11 |