NPI | 1164730768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59727) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 59727) |
Enumeration Date | 2010-09-16 |
Last Update Date | 2023-06-14 |