| NPI | 1851656375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30-023733) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SD D1324) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2021-08-18 |