NPI | 1336568823 |
---|---|
Former Name | TAYLOR JIEUN NORTHERN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: AL D-0007005-C) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208600000X Surgery (Licence: OK 35599) | |
Enumeration Date | 2014-04-10 |
Last Update Date | 2022-11-14 |