| NPI | 1184216756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OH 71.000291) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MI 2901600801) |
| 1223P0300X Dentist, Periodontics (Licence: IA 40203) | |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2024-10-22 |