NPI | 1053650655 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 54613) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL RDH11724) |
Enumeration Date | 2013-02-04 |
Last Update Date | 2022-09-27 |