| NPI | 1942343108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10511) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 21512) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2018-08-20 |