NPI | 1447874219 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D11294) |
Additional Taxonomies | 122300000X Dentist (Licence: OR D11294) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-06-08 |
Last Update Date | 2023-07-12 |