| NPI | 1265926398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH RES.004015) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025506) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-08-02 |