| NPI | 1720658131 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OH RES.004352)  | 
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: GA DN123050)  | 
| Enumeration Date | 2021-06-28 | 
| Last Update Date | 2023-08-10 |