NPI | 1104569862 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NY 063847) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 109285) |
122300000X Dentist (Licence: VA 0401417957) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-04-19 |
Last Update Date | 2024-07-26 |