NPI | 1679703375 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64240) |
Additional Taxonomies | 122300000X Dentist (Licence: MN D12730) |
Enumeration Date | 2009-07-16 |
Last Update Date | 2022-02-11 |