NPI | 1063665180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA A110357) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA OMS 90) |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 055245) | |
Enumeration Date | 2008-11-03 |
Last Update Date | 2011-10-19 |