NPI | 1295476794 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: OK 7983) |
Additional Taxonomies | 122300000X Dentist (Licence: MN D14864) |
122300000X Dentist (Licence: TX 38614) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-04-06 |
Last Update Date | 2025-01-30 |