NPI | 1073195756 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 108436) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 13324) |
Enumeration Date | 2021-04-22 |
Last Update Date | 2023-05-27 |