| NPI | 1457460511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30-022372) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30-022372) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-07-21 |