| NPI | 1841541844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901021389) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.023844) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2015-12-10 |