NPI | 1225619398 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 108305) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE61142655) |
Enumeration Date | 2021-04-19 |
Last Update Date | 2022-10-21 |