NPI | 1811305345 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025579) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025579) |
Enumeration Date | 2014-07-29 |
Last Update Date | 2021-12-27 |