| NPI | 1457732513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 103607) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30-024521) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-02-12 |