| NPI | 1831760487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026572) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN26134) |
| 122300000X Dentist (Licence: FL 26134) | |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2021-07-06 |