| NPI | 1447431523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 23473) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OH 30022665) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2022-01-24 |