NPI | 1477811651 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 104830) |
Additional Taxonomies | 122300000X Dentist (Licence: NV 7448) |
122300000X Dentist (Licence: MI 2901021804) | |
Enumeration Date | 2012-04-25 |
Last Update Date | 2024-07-09 |