| NPI | 1346467024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: PR 2568) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.024571) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2015-07-17 |