| NPI | 1659892024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: PA DS044486) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 102851) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2025-01-13 |