| NPI | 1306900972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: OH 30018835) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30018835) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-05-28 |