| NPI | 1942748173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OH 30025062) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30025062) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2018-07-24 |