NPI | 1669026423 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 103890) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 103890) |
Enumeration Date | 2019-07-30 |
Last Update Date | 2024-07-31 |