| NPI | 1750908638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026180) |
| Additional Taxonomies | 122300000X Dentist (Licence: AK 233149) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2025-10-14 |