| NPI | 1952455073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN012334) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30019014) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-09-27 |