NPI | 1245536804 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 58660) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 58660c) |
Enumeration Date | 2011-01-31 |
Last Update Date | 2014-03-14 |