| NPI | 1801970835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901019191) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30022458) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2011-11-07 |