| NPI | 1568819258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30.025129) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: WI 1001290 - 15) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2020-12-26 |