| NPI | 1265949903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN26760) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: VT 0160133837) |
| 1223G0001X Dentist General Practice (Licence: OH 30.026064) | |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2022-05-12 |