| NPI | 1922309418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN014457) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-023334) |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2022-07-11 |