| NPI | 1013887108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MD 19089) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 30.028213) |
| Enumeration Date | 2025-11-05 |
| Last Update Date | 2025-11-05 |