| NPI | 1801388764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IA DDS-09736) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN27828) |
| 122300000X Dentist (Licence: OH 30.025459) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2023-05-09 |