| NPI | 1396898805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30022503) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS036998) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2012-08-29 |