| NPI | 1922556356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: KY 9253) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9253) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2019-10-18 |