NPI | 1447619895 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 102564) |
Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00203104) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-02-14 |
Last Update Date | 2019-04-28 |