NPI | 1649646852 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 0401414911) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 64616) |
Enumeration Date | 2015-08-11 |
Last Update Date | 2015-08-11 |