| NPI | 1508480484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.027842) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 38161) |
| 1223G0001X Dentist, General Practice (Licence: NC 11833) | |
| 1223G0001X Dentist, General Practice (Licence: OH 30.027842) | |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2025-05-19 |