| NPI | 1891142808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN22334) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.024942) |
| 122300000X Dentist (Licence: CO DEN.00203088) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2022-04-15 |