| NPI | 1568743839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 71.000282) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DF11903) |
| 122300000X Dentist (Licence: NC 2000025400379) | |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2023-12-01 |