NPI | 1881197960 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 062432) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 12198) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL DN24047) | |
Enumeration Date | 2018-03-14 |
Last Update Date | 2024-09-18 |