NPI | 1215225131 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.023914) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.028695) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-07-12 |
Last Update Date | 2019-10-01 |