| NPI | 1760163810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.027373) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00205797) |
| 122300000X Dentist (Licence: ID D5531) | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-11-21 |