NPI | 1023458064 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 45029) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 45029) |
Enumeration Date | 2013-07-03 |
Last Update Date | 2022-05-01 |