NPI | 1346459930 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PA DS022405L) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: OH 30.018182) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2007-07-08 |