NPI | 1154603348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 204400) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 60827) |
Enumeration Date | 2011-09-13 |
Last Update Date | 2021-09-28 |