| NPI | 1720763535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OH DN30.028052) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OH 30.028052) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2025-08-26 |