NPI | 1497323315 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D012242) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1223G0001X Dentist, General Practice (Licence: FL DN27006) | |
Enumeration Date | 2021-06-16 |
Last Update Date | 2024-07-05 |