| NPI | 1003901059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30019917) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: OH 30-019917) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2022-04-21 |