NPI | 1639703408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL dn27284) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DRPM2148) |
Enumeration Date | 2020-03-02 |
Last Update Date | 2022-07-18 |