NPI | 1730709320 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI02871900) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858754) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-04-23 |
Last Update Date | 2022-08-10 |