| NPI | 1629056213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.024238) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: WV 3540) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2024-04-10 |