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 |