| NPI | 1528636024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11620) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES.004379) |
| Enumeration Date | 2021-06-12 |
| Last Update Date | 2022-08-17 |