| NPI | 1063871630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.026146) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 9841) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2023-11-06 |