| NPI | 1093564882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.027533) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 11282) |
| 1223G0001X Dentist, General Practice (Licence: OH 30.027533) | |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2025-02-18 |