NPI | 1205458627 |
---|---|
Other Name | SHELBY LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CT 13057) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-05-07 |
Last Update Date | 2021-06-28 |