| NPI | 1134311004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 64251) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.022632) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.022632) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2016-04-19 |