NPI | 1194334136 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 40028) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OH 004289) |
Enumeration Date | 2020-07-27 |
Last Update Date | 2025-05-15 |