NPI | 1447698626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 63304) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60972) |
Enumeration Date | 2013-06-10 |
Last Update Date | 2016-10-28 |