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 |