NPI | 1689006173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1856783) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62772) |
Enumeration Date | 2013-08-06 |
Last Update Date | 2018-04-17 |