NPI | 1669112041 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 111640) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 111640) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 13412) | |
Enumeration Date | 2022-03-31 |
Last Update Date | 2025-08-11 |