| NPI | 1225124548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30019258) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.019258) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-04-04 |