| NPI | 1487974705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.023179) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-023179) |
| 122300000X Dentist (Licence: TX 28193) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2012-11-29 |