NPI | 1780950287 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413945) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413945) |
1223G0001X Dentist, General Practice (Licence: NJ 22D102530000) | |
1223P0221X Dentist, Pediatric Dentistry (Licence: TX 34799) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-03-28 |
Last Update Date | 2022-09-17 |