| NPI | 1982628467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: SC 4193) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4193) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-12-04 |