NPI | 1962879148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: DC DEN1001876) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
122300000X Dentist (Licence: FL DN20925) | |
Enumeration Date | 2015-08-24 |
Last Update Date | 2018-11-06 |