NPI | 1093281156 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 103471) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401416312) |
Enumeration Date | 2018-10-16 |
Last Update Date | 2019-01-12 |