| NPI | 1417063330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30-022638) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 20508) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901018257) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2014-02-13 |