| 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 |