NPI | 1225596380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA GA2108) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-07 |
Last Update Date | 2022-09-16 |