NPI | 1881976371 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.24868) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH RES.3048) |
Enumeration Date | 2011-09-12 |
Last Update Date | 2016-08-22 |