NPI | 1033453667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 61647) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 61647) |
Enumeration Date | 2012-11-20 |
Last Update Date | 2023-07-31 |