| NPI | 1225318389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30023492) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-023492) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2016-11-21 |