NPI | 1093396509 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 062519) |
Enumeration Date | 2021-04-16 |
Last Update Date | 2024-05-13 |