NPI | 1821643206 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 4396) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL DRPM2045) |
Enumeration Date | 2019-08-02 |
Last Update Date | 2021-06-28 |