NPI | 1275521072 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS105814) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00009812) |
Enumeration Date | 2005-10-06 |
Last Update Date | 2021-07-11 |