NPI | 1043422520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 55174) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 5100) |
1223G0001X Dentist, General Practice (Licence: PA DS036880) | |
Enumeration Date | 2007-05-04 |
Last Update Date | 2019-09-05 |