| NPI | 1992985295 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AZ D7127) | 
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D7127) | 
| 1223X2210X Dentist, Orofacial Pain (Licence: AZ D7127) | |
| Enumeration Date | 2007-11-05 | 
| Last Update Date | 2022-12-05 |