| NPI | 1639912496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401419626) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES.004825) |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2025-07-18 |