| NPI | 1821782079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN R856) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.034465) |
| 1223X2210X Dentist, Orofacial Pain (Licence: MA DN10000934) | |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2025-12-18 |