| NPI | 1992585087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026986) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS035101) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |