NPI | 1518148436 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 58100) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 5675) |
Enumeration Date | 2007-11-19 |
Last Update Date | 2010-07-27 |