| NPI | 1528295524 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30-023298)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 2846)  | 
| Enumeration Date | 2009-06-17 | 
| Last Update Date | 2012-08-15 |