| NPI | 1598264285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025695) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025695) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2019-05-22 |