| NPI | 1679167621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 12371) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026752) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.026752) | |
| Enumeration Date | 2021-02-21 |
| Last Update Date | 2024-01-28 |