| NPI | 1356460216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D11499) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30021651) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2016-08-11 |