| NPI | 1902176860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8937) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: TX 1738) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2022-07-21 |