NPI | 1073533808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 51752) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS023024L) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2016-10-24 |