NPI | 1447904537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 12785) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 12785) |
Enumeration Date | 2022-02-08 |
Last Update Date | 2024-06-17 |