NPI | 1255426821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43338) |
Additional Taxonomies | 122300000X Dentist (Licence: HI DT-1929) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2012-02-23 |