| NPI | 1356791446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 9281) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.024988) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2019-01-31 |