| NPI | 1699174391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA DDS-09866) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30024633) |
| 1223G0001X Dentist, General Practice (Licence: SC 8337) | |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2021-11-12 |