| NPI | 1386738086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 60132) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30022420) |
| 1223G0001X Dentist, General Practice (Licence: OH 30-022420) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-01-24 |