NPI | 1174870497 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 61606) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 61606) |
Enumeration Date | 2012-08-06 |
Last Update Date | 2016-01-13 |