NPI | 1881181329 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019034244) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 34804) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-19 |
Last Update Date | 2023-07-27 |