| NPI | 1801870472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30023842) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 46573) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2016-08-17 |