| NPI | 1003957648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.022271) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 5084) |
| 1223G0001X Dentist, General Practice (Licence: CA 55341) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-12-01 |