| NPI | 1083005540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OH 30.025210) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH RES3522) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2018-09-18 |