NPI | 1659810778 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KS 61608) |
Additional Taxonomies | 122300000X Dentist (Licence: KS 61608) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-02-22 |
Last Update Date | 2020-09-05 |