| NPI | 1255546503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.025253) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 7034) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-09-10 |