NPI | 1669106548 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DN122781) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN122781) |
Enumeration Date | 2022-07-15 |
Last Update Date | 2023-06-30 |