| 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 |