| NPI | 1336289149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 14233) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30022442) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401411804) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2013-06-12 |