| NPI | 1194812958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OH 30-022240) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-022240) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-04-21 |