NPI | 1649669888 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 64262) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 64262) |
Enumeration Date | 2015-01-12 |
Last Update Date | 2022-07-05 |