| NPI | 1730799933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: KY 10007) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10007) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-10-05 |