NPI | 1518104678 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 55841) |
Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: CA 55841) |
1223G0001X Dentist, General Practice (Licence: CA 55841) | |
Enumeration Date | 2009-01-12 |
Last Update Date | 2014-11-26 |