| NPI | 1740669043 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.024453)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.024453)  | 
| Enumeration Date | 2015-05-20 | 
| Last Update Date | 2023-06-16 |