| NPI | 1972823375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401416429) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: OH 30-023319) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2021-07-06 |