| NPI | 1669851259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.027626) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 32596) |
| 122300000X Dentist (Licence: MD 15851) | |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2024-06-26 |