| NPI | 1609187376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30-023270) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.023270) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2011-12-08 |