| NPI | 1477747368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: KY 949) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 8579) |
| 1223E0200X Dentist Endodontics (Licence: OH 30.022999) | |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2016-08-22 |