| NPI | 1801159637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 15230) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.027804) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 1229) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2025-05-02 |