NPI | 1215284195 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64665) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 10830) |
Enumeration Date | 2012-08-09 |
Last Update Date | 2016-12-07 |