NPI | 1689037905 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MN 14021) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA 30480) |
Enumeration Date | 2016-04-04 |
Last Update Date | 2021-05-10 |