NPI | 1386805695 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 107361) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 154369) |
1223G0001X Dentist, General Practice (Licence: OH 30.022809) | |
Enumeration Date | 2008-06-19 |
Last Update Date | 2025-10-03 |