NPI | 1689237596 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA DDS109502) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D010779) |
Enumeration Date | 2019-04-16 |
Last Update Date | 2024-04-18 |