NPI | 1154675155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 65269) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE60307748) |
Enumeration Date | 2012-10-30 |
Last Update Date | 2018-07-16 |