NPI | 1013376904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02674200) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1223G0001X Dentist, General Practice (Licence: RI DEN03348) | |
Enumeration Date | 2016-02-19 |
Last Update Date | 2018-03-29 |