NPI | 1619126943 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 57464) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 28774) |
1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 1535) | |
1223G0001X Dentist, General Practice (Licence: TX 28774) | |
Enumeration Date | 2008-09-10 |
Last Update Date | 2021-09-12 |