NPI | 1205386612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 65083) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN22199) |
Enumeration Date | 2016-10-10 |
Last Update Date | 2022-02-02 |