| NPI | 1215910930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 18372) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30022159) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2010-01-13 |