| NPI | 1386805695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 107361) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 30.022809) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2024-12-13 |