| NPI | 1326003922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 21710) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 0382344) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2009-11-10 |