NPI | 1235790189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 103803) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 103803) |
Enumeration Date | 2019-06-21 |
Last Update Date | 2024-06-10 |