NPI | 1437440260 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 60257) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL DN17300) |
Enumeration Date | 2011-04-27 |
Last Update Date | 2016-06-10 |