| NPI | 1417260712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: WI 7188-15) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 30-023210) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2014-01-10 |