| NPI | 1518058684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS036640) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025237) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2023-03-07 |