| NPI | 1861516486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA California 47869) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH Ohio 30021816) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2008-02-26 |