NPI | 1538565510 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 63288) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 057586) |
Enumeration Date | 2014-11-18 |
Last Update Date | 2016-10-19 |