NPI | 1013961853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 52752) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 52752) |
Enumeration Date | 2006-05-19 |
Last Update Date | 2007-07-08 |