| NPI | 1699330449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30025986) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901023194) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901023194) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2021-10-11 |