| NPI | 1912624511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30.027416) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NC 13243) |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2024-02-29 |