| NPI | 1902666720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: WA DE61444295) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WA DE61444295) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-11-09 |