| NPI | 1689026494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30.025186) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PA DS040851) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2022-01-06 |