NPI | 1568887768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 057928) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401414827) |
1223G0001X Dentist, General Practice (Licence: GA DN122644) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-02-25 |
Last Update Date | 2025-10-05 |