| NPI | 1326748583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.027395) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY D-00123) |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2026-04-07 |