NPI | 1588022065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 101758) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 101758) |
Enumeration Date | 2016-01-29 |
Last Update Date | 2020-06-16 |