NPI | 1225646706 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 104998) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 104998) |
Enumeration Date | 2020-07-21 |
Last Update Date | 2020-07-21 |