NPI | 1003265604 |
---|---|
Former Name | BAMBI MBIYE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 102314) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-06-06 |
Last Update Date | 2018-08-01 |