| NPI | 1992399893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 17426) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 17426) |
| 122300000X Dentist (Licence: OH 30.026763) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.026763) | |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2023-10-31 |