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 |