| NPI | 1861629099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: OH 00845) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 00845) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2009-06-15 |