| NPI | 1861640625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NV 7274) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 30-022946) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2021-01-12 |