| NPI | 1861786071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.023792) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.028615) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-12-14 |