| NPI | 1518256056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025334) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NE 6948) | |
| 122300000X Dentist (Licence: OH 30.025334) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2019-09-03 |