NPI | 1275289209 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40045) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 11919) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-02-28 |
Last Update Date | 2023-09-27 |