| NPI | 1730193517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: CA 36196) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 36196) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 36196) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2026-06-01 |