NPI | 1699349076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2901601470) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2952000756) |
Enumeration Date | 2021-05-19 |
Last Update Date | 2023-04-05 |