NPI | 1568440642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OH 30019865) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MD 11718) |
Enumeration Date | 2006-01-09 |
Last Update Date | 2007-07-08 |