NPI | 1386102671 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 019.033502) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL 24704) |
1223G0001X Dentist, General Practice (Licence: SC 9563) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-06 |
Last Update Date | 2022-07-14 |