| NPI | 1184670150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AZ 7054) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 21975) |
| 1223G0001X Dentist General Practice (Licence: CA 49659) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-07-08 |