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 |