| NPI | 1073008959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: OR D11695) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223G0001X Dentist General Practice (Licence: OH 30.026292) | |
| 1223P0221X Dentist Pediatric Dentistry (Licence: OH 30.026292) | |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2023-02-11 |