| NPI | 1962070409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH APP-000457665) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH APP-000466973) |
| Enumeration Date | 2021-06-11 |
| Last Update Date | 2023-03-30 |