NPI | 1114017977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 57715) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 4912) |
122300000X Dentist (Licence: CA 57715) | |
Enumeration Date | 2006-10-13 |
Last Update Date | 2013-12-11 |