| NPI | 1891059010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.024295) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH RES.3159) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2014-07-14 |