| NPI | 1043485287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64482) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES.2595) |
| 1223G0001X Dentist, General Practice (Licence: MN D12276) | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2022-08-18 |