| NPI | 1639824535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OH 30.027092) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.027092) |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2023-05-18 |