| 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 |