| NPI | 1992153985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 36413) |
| Additional Taxonomies | 1223X2210X Dentist, Orofacial Pain (Licence: TX 36413) |
| 208600000X Surgery (Licence: TX T6532) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2023-06-05 |