NPI | 1144965377 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MA DN10000722) |
Additional Taxonomies | 122300000X Dentist (Licence: MN D14938) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-05-02 |
Last Update Date | 2025-07-02 |