| NPI | 1528553302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OH 30.026425) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026425) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-03-25 |