NPI | 1588825418 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60884) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 10047) |
1223G0001X Dentist, General Practice (Licence: TX 24513) | |
Enumeration Date | 2008-06-23 |
Last Update Date | 2014-10-17 |