| NPI | 1194390062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.027069) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH RES.004339) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2023-05-20 |