NPI | 1710392881 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 64414) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-06-26 |
Last Update Date | 2020-07-27 |