NPI | 1740849686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 39351) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.025840) |
1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025840) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 12865) | |
Enumeration Date | 2019-06-12 |
Last Update Date | 2024-03-04 |