| NPI | 1891143251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30.027045) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021910) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2023-07-07 |