NPI | 1508351990 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD5090) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX ETN530) |
Enumeration Date | 2018-06-27 |
Last Update Date | 2019-07-14 |