| NPI | 1669995296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: CA 101624) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101624) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2023-04-27 |