NPI | 1760068001 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 122300000X Dentist (Licence: NY 062439) |
1223G0001X Dentist, General Practice (Licence: VA 0401417914) | |
1223G0001X Dentist, General Practice (Licence: DC DEN2000281) | |
Enumeration Date | 2021-03-18 |
Last Update Date | 2025-05-04 |