| NPI | 1730345737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.022890) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 053938) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2022-07-21 |