| NPI | 1942942040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.027710) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 133160509923) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-09 |
| Last Update Date | 2026-04-18 |