NPI | 1932639994 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 37470) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 203989) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-06-13 |
Last Update Date | 2021-08-12 |