| NPI | 1881352698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN27801) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026682) |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2023-08-13 |