NPI | 1053973735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NY 061248) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02809700) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-07-02 |
Last Update Date | 2020-11-23 |