NPI | 1528615614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 104112) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 104112) |
Enumeration Date | 2019-08-22 |
Last Update Date | 2022-12-27 |