NPI | 1447796636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 104703) |
Additional Taxonomies | 122300000X Dentist (Licence: NV 6866) |
Enumeration Date | 2017-01-11 |
Last Update Date | 2020-08-13 |