NPI | 1104112390 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA CA63169) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS038796) |
Enumeration Date | 2011-06-26 |
Last Update Date | 2022-01-06 |