| NPI | 1972061117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.026052) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.026052) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2022-12-12 |