| NPI | 1437479813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901020340) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH RES.2942) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2014-12-10 |