NPI | 1487020772 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: AZ D009357) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 65008) |
Enumeration Date | 2015-08-20 |
Last Update Date | 2015-11-10 |