| NPI | 1174216691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901602242) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES.004638) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2025-02-19 |