NPI | 1104230838 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 32105) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 63372) |
Enumeration Date | 2014-06-20 |
Last Update Date | 2016-11-02 |