NPI | 1013900620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 52834) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 52834) |
Enumeration Date | 2005-08-30 |
Last Update Date | 2025-02-05 |