NPI | 1285174102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 35092) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 102545) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-02-24 |
Last Update Date | 2019-08-11 |