| NPI | 1073174637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN25552) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH APP-000261372) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2025-08-25 |