NPI | 1609372598 |
---|---|
Former Name | JAEHEE JEON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 105277) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 105277) |
122300000X Dentist (Licence: FL DN23879) | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN23879) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-01 |
Last Update Date | 2021-06-23 |