NPI | 1912647066 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.027806) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.027806) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-03-29 |
Last Update Date | 2025-02-24 |