| NPI | 1770286510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2024033375) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES004649) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-08-24 |