| NPI | 1740842251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.025901) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24246) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2019-07-03 |