| NPI | 1003891748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: OH 30.020955) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: CA 53140) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2023-08-03 |