| NPI | 1952157141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH RES.004743) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.028602) |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2026-07-05 |