| NPI | 1326782723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: OH RES.004462) |
| 122300000X Dentist (Licence: FL DN27453) | |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2023-06-20 |