NPI | 1073997409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 105715) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 058541-1) |
Enumeration Date | 2015-07-15 |
Last Update Date | 2023-01-16 |