NPI | 1629764600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019.036109) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 109670) |
Enumeration Date | 2023-04-13 |
Last Update Date | 2025-07-11 |