NPI | 1639557739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS105848) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857629) |
1223G0001X Dentist, General Practice (Licence: CA 105848) | |
Enumeration Date | 2015-05-11 |
Last Update Date | 2021-06-23 |