NPI | 1083101315 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 060467) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 060467) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-23 |
Last Update Date | 2024-07-10 |