NPI | 1548729775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 061989) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL dn24808) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-18 |
Last Update Date | 2021-09-03 |