NPI | 1265777114 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA BW1389255) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 37181) |
Enumeration Date | 2012-12-04 |
Last Update Date | 2012-12-04 |