NPI | 1538780390 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: WA 61158728) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 390200000X) |
Enumeration Date | 2020-05-04 |
Last Update Date | 2024-08-05 |