NPI | 1528514536 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OH 30.026369) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH RES.3771) |
Enumeration Date | 2016-08-30 |
Last Update Date | 2022-06-06 |