| NPI | 1316106974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30022749) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019877) |
| Enumeration Date | 2008-06-08 |
| Last Update Date | 2017-02-17 |