| NPI | 1467714931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31489) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.023476) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2016-02-20 |