NPI | 1205044237 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 49135) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: HI 2713) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2022-07-21 |