NPI | 1639531460 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN23246) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16196) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-22 |
Last Update Date | 2022-07-26 |