| NPI | 1114161940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WV 3870) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 3970) |
| 122300000X Dentist (Licence: OH IN PROCESS) | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2020-05-21 |