| NPI | 1467951806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025693) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025693) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 11913) | |
| Enumeration Date | 2018-02-11 |
| Last Update Date | 2024-01-12 |