NPI | 1619289105 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 108080) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2010016145) |
122300000X Dentist (Licence: CO 10515) | |
122300000X Dentist (Licence: OK 6218) | |
Enumeration Date | 2010-07-13 |
Last Update Date | 2023-04-21 |