| NPI | 1972717346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: DC DEN3912) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MD 7710) |
| 1223G0001X Dentist General Practice (Licence: VA 0401006199) | |
| 1223G0001X Dentist General Practice (Licence: OH 30017217) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |