| NPI | 1306995840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: IA 40125) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: OH 30019213) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2011-08-29 |