| NPI | 1750443545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30-023115) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 8430) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2014-08-20 |