NPI | 1255725115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 105884) |
Additional Taxonomies | 122300000X Dentist (Licence: ND 2295) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-03-27 |
Last Update Date | 2022-04-22 |