| NPI | 1154623379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN19443) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OH 30023354) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2024-02-22 |