NPI | 1700579182 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.034325) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019.034325) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-05-31 |
Last Update Date | 2023-06-15 |