| NPI | 1467402453 |
|---|---|
| Former Name | LOUIS JERRY MAYO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 18689) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30-01-8689) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-03-03 |