NPI | 1194954180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 59622) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 390200000x) |
Enumeration Date | 2009-07-10 |
Last Update Date | 2017-01-05 |