| NPI | 1649465089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN18013) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.022640) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2011-12-01 |