NPI | 1245254374 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 58818) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901018718) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2009-12-19 |