| 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 |