NPI | 1144581703 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-238) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 61134) |
122300000X Dentist (Licence: NV 5982) | |
Enumeration Date | 2012-05-30 |
Last Update Date | 2013-06-17 |