| NPI | 1376697870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.023859) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.023859) |
| 1223G0001X Dentist, General Practice (Licence: NY 052679) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2024-03-21 |