| NPI | 1699187732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30-024417) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30-024417) |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2019-06-17 |