| NPI | 1225648017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 40041) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES.004283) |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2023-09-25 |