NPI | 1376030296 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D11684) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1858414) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-16 |
Last Update Date | 2022-12-22 |