| NPI | 1508852047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 22003) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 23169) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2025-10-01 |