| NPI | 1922414184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OH 30025166) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH RES3495) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2023-10-11 |