NPI | 1952750382 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 103530) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D010147) |
1223G0001X Dentist, General Practice (Licence: MA DN1857705) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-06-07 |
Last Update Date | 2019-02-05 |