| NPI | 1144475658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 9603) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30-022738) |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2014-08-27 |