NPI | 1154690196 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA DDS104187) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN19594) |
Enumeration Date | 2011-12-20 |
Last Update Date | 2020-10-28 |