| NPI | 1598262404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN123508) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD LL840) |
| 1223G0001X Dentist, General Practice (Licence: OH 30.025930) | |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2025-01-21 |