| NPI | 1508477670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.027377) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7383) |
| 1223G0001X Dentist, General Practice (Licence: CO DEN.00204625) | |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2024-07-25 |