| NPI | 1881792414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D5885) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.021887) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-02-28 |