| NPI | 1548473663 |
|---|---|
| Former Name | ELIZABETH MARIE MIKOTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30019095) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |