| NPI | 1548287493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30691) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 21947) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2016-01-20 |