| NPI | 1922737790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.027952) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 38613) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2025-11-07 |