| 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 |