NPI | 1619559911 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 40219) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 7629TU) |
390200000X Student in an Organized Health Care Education/Training Program | |
1223G0001X Dentist, General Practice (Licence: NV LL-558-21) | |
Enumeration Date | 2021-04-26 |
Last Update Date | 2024-02-22 |