NPI | 1245689959 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 106145) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021922) |
Enumeration Date | 2016-06-03 |
Last Update Date | 2022-09-13 |