| NPI | 1427544170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OH 30.026411) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: LA S-967) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2022-06-03 |