| NPI | 1750400099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AK 1182) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-022199) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-11-18 |