NPI | 1144803313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: PA DS044384) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 108019) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-05-04 |
Last Update Date | 2023-11-27 |