| NPI | 1194941351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30 020404) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30020404) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-03-24 |