| NPI | 1063072981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: OH 30.027420) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS042587) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2024-08-13 |