NPI | 1639590474 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: GA DN015969) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 62623) |
Enumeration Date | 2013-12-20 |
Last Update Date | 2024-06-14 |