NPI | 1376708933 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D14051) |
Additional Taxonomies | 122300000X Dentist (Licence: OR D9120) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 08796) | |
Enumeration Date | 2008-07-23 |
Last Update Date | 2021-02-10 |