NPI | 1174106447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA DDS108695) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D011146) |
Enumeration Date | 2021-05-04 |
Last Update Date | 2023-08-30 |