| NPI | 1861844912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026745) |
| Additional Taxonomies | 122300000X Dentist (Licence: WI 1001798-15) |
| 1223G0001X Dentist, General Practice (Licence: KY 9821) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2022-06-15 |