| NPI | 1720672678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OH 30.026742) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026742) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2022-04-26 |