| NPI | 1881120582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 13709) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025784) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 17539) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401417350) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 260191) | |
| 1223G0001X Dentist, General Practice (Licence: MI 2901022349) | |
| 1223G0001X Dentist, General Practice (Licence: MD 17539) | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2024-06-21 |