| NPI | 1033557467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 9787091-9922) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.023995) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2016-06-23 |