NPI | 1962716449 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 055979-1) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
1223E0200X Dentist, Endodontics (Licence: CT 010966) | |
Enumeration Date | 2010-07-27 |
Last Update Date | 2013-07-29 |