| NPI | 1114452661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025107) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA Y3156130) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2019-09-30 |