| NPI | 1457391724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30-023646) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 3546) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2012-04-05 |