NPI | 1346374840 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 38425) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901018813) |
1223G0001X Dentist, General Practice (Licence: MI 2901018813) | |
Enumeration Date | 2007-03-15 |
Last Update Date | 2022-06-16 |