NPI | 1487809752 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: OR D10053) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR H5021) |
Enumeration Date | 2008-11-29 |
Last Update Date | 2014-07-08 |