NPI | 1295212736 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2023024851) |
Enumeration Date | 2018-07-27 |
Last Update Date | 2023-10-25 |