| NPI | 1912585126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: MI 2952000810) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN S-167) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2952000810) | |
| 1223X2210X Dentist, Orofacial Pain (Licence: MN S167) | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2023-03-28 |