| NPI | 1124505888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D10855) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH RES.004457) |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2022-07-28 |