NPI | 1982299236 |
---|---|
Former Name | VIRTUE EBOHI AKHIDIME |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 39325) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 39325) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-03-08 |
Last Update Date | 2024-09-20 |