NPI | 1679034540 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019032181) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.032181) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-25 |
Last Update Date | 2023-01-16 |