| NPI | 1134282007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30-021877) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 21877) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2026-01-28 |