NPI | 1194984104 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47136) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA 8355) |
1223G0001X Dentist, General Practice (Licence: AZ 5836) | |
Enumeration Date | 2008-06-04 |
Last Update Date | 2015-01-10 |