| NPI | 1164914685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 37890) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OH RES.003931) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2026-01-29 |