| NPI | 1003195017 |
|---|---|
| Former Name | JOI E. STALLWORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.025001) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 9437) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2018-02-26 |