NPI | 1508849241 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 36603) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA B36603) |
Enumeration Date | 2005-11-28 |
Last Update Date | 2020-03-10 |