NPI | 1265880470 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: SC 10831) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1223G0001X Dentist, General Practice (Licence: TN 10500) | |
Enumeration Date | 2016-05-27 |
Last Update Date | 2024-12-03 |