NPI | 1699825745 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47841) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT 2049) |
1223G0001X Dentist, General Practice (Licence: CO 9255) | |
Enumeration Date | 2007-01-11 |
Last Update Date | 2007-07-08 |