NPI | 1083756944 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 54865) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA CA54865) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2018-04-18 |