| NPI | 1669025599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.027637) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D14293) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2024-09-18 |