| NPI | 1508327784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1859741) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30026097) |
| 1223G0001X Dentist, General Practice (Licence: NC 12632) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-02-27 |