NPI | 1477962330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 62285) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: WA 60725851) |
Enumeration Date | 2014-08-05 |
Last Update Date | 2018-09-05 |