| NPI | 1275088866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.025626) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025626) |
| 122300000X Dentist (Licence: KY 9849) | |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2023-02-02 |